Healthcare from the perspective of a clinician encompassing both the capture of the clinical viewpoint as well as the technology to help clinicians capture knowledge at the point of care
The thoughts expressed are my own and do not necessarily represent those of Nuance

Tuesday, March 24, 2015

Health and fitness apps, smart devices and connected products are making us more aware of our own health—and more active participants in our efforts to stay healthy. At the same time, health providers are looking to technology for smarter ways to deliver quality care, whether we are in the hospital or at home.

Wearable technology - 80% of consumers would benefit from the use of wearable technology

Connected devices - Using remote monitoring to reduces readmissions

EHRs - 71% of physicians now use EHRs and 85% meeting current meaningful standards

Telehealth 70% patients comfortable communicating with their doctor using digital technology vs hauling themselves in to the officer

Predictive analytics - More than 80% of standard tasks (BP, glucose etc) and even complex testing (e.g. genomics) will change the way we deliver care as described by Eric Topol​ in "The Patient Will See You Now"

Saturday, March 14, 2015

Today is super-pi day, a day that comes but once a century and extends to a specific time at 9:26:53 seconds (although when that occurs will depends on your time zone. While pi is an infinite non-repeating decimal, there are still mathematicians and scientists seeking to build computers that can run the computation and see how far they can plot the number. As Spock put it:

"Pi as we know the value of Pi is a transcendental figure without resolution"

Here’s to those who choose to defy reality and instead envision a future world – a world that ventures beyond even Mr. Spock’s wildest dreams.

The sad news of Leonard Nimoy’s passing has spurred tributes to not only to his life and craft, but to Star Trek, and what it has meant to so many over the years. In talking with my friends and colleagues, it seems that regardless of age, most Trekkies are also techies.

One of the neatest things about working in technology is that you inhabit two worlds. The first is our everyday reality—with all of its joys, frustrations, celebrations, and inconveniences. This world has soft tender moments tempered by harsh truths; it is simultaneously disappointing and inspiring.

But from this disappointment is born opportunity and a vision for the future world. Here is where Star Trek is a reality, where innovators take those every day frustrations and disappointments as ask themselves how things can be done better.

I’m lucky to work alongside some incredibly innovative, talented minds and whether in R&D or client services, at the core, we all share an inquisitiveness that pulls us from one orbit to another.

“I grew up watching Captain Kirk, Spock, and the Enterprise crew boldly go where no man has gone before. In the 1980s, Star Trek was big in India and it ignited our collective sparks of creativity and imagination. In fact, as school children, we learned to make “communicators” with matchboxes and rubber bands. When I grew up, I realized this type of voice-activated technology could be a reality, and I have dedicated my career to making that vision something that is accessible to everyone. I still wonder how close our technology today is to what Gene Roddenberry had imagined when he created Star Trek.”

- Vivek Kaluskar, Nuance Natural Language Processing Researcher

“Star Trek introduced me to the idea of being able to talk to a computer, and have it understand and respond. That’s actually what got me into speech-recognition technology: it was that sense of wonder about making technology collaborative—where you could ask a device a question and it could parse through vast amounts of data to help you do something faster.

The show also got me interested in science fiction, which has proven to be an enduring affection. It’s amazing to step back and see many ideas that seemed outlandish, like tractor beams, talking computers, matter transmission, and warp drives, are either becoming a reality, or are being researched and developed. Science fiction, in many ways, has created a technological roadmap for the future. It reminds us to keep dreaming and keep asking ‘why can’t we do that?’”

- Ignace Van Caneghem, Nuance Customer Support Specialist

Finding solutions to seemingly impossible situations is what innovators do. It’s why we wake up in the morning. I’m constantly looking for ways to make health IT more connected, accessible, and more intuitive so physicians can focus on treating their patients.

Working in tech isn’t easy, but some of the most worthwhile pursuits are also the most challenging. Thinking outside the box is the key to solving complex problems. There’s an episode of Star Trek (“Wolf in the Fold,” 1967) where Spock forces an alien entity out of the ship’s computer by asking it to calculate pi to the last digit, an impossible feat. At that time, using speech recognition to control a computer was also impossible.

We are a lot closer to the Hollywood vision that’s been in our minds since 1967, creating innovative technology that continues to amaze us at an incredible pace. It was this sense of amazement, instilled by the creative mind of Gene Rodenberry, which helped open my eyes to the potential for healthcare technology to touch not just hundreds, but millions of patients through innovation.

This Saturday is Super Pi Day, a day that comes but once a century. While pi is an infinite non-repeating decimal, there are still mathematicians and scientists seeking to build computers that can run the computation, see how far they can plot the number. Here’s to those who chase the impossible. To those who know there is a better way to do things and dare to keep asking “how?” They choose to live between two worlds and they are building the future. Super-pi day is for you.

Monday, March 2, 2015

2015 health IT innovation holds the promise of turning massive amounts of personal health data into usable information that can keep you healthier -- and it's conveniently accessible on your phone.

It’s always comical to watch movies from the 1980s, not only for the distinct style choices that typified that decade, but to see the type of technology most of us can still recall using. It’s nearly impossible to believe we used to happily lug around three pound mobile phones with antennas and back-up battery packs, but they offered a convenience the likes of which we had never seen before. While heading to the 2015 Mobile World Congress (MWC)

one of the most prominent tradeshows in the tech industry, I couldn’t help but think about the pace of change and get excited about the digital health innovations that will be showcased.

We tend to take for granted the conveniences and time-saving effects such innovation has on our lives. Prior to the pervasiveness of mobile technology, if you were walking down the street and you saw someone collapse, you would need to find the nearest store or phone booth to call for help. In fact, most of us probably knew which corners on our daily commute had pay phones. Now, even if you’ve left your phone in the car (an unthinkable these days) you can comfortably rely on the fact that someone nearby will have theirs in the case of an emergency.

Is your heart in it?

From a healthcare perspective, the interconnectivity of devices is fascinating and holds a lot of potential for engaging patients and improving health outcomes. Innovations such as smart watches, which are being outfitted with fitness trackers and heart rate monitoring sensors, can alert the wearer he has achieved 10,000 steps that day or that a runner has reached her target heart rate

While innovations such as these are always exciting, the bigger picture is about creating a healthier population. According to the World Health Organization, cardiovascular disease is the number one cause of death in the world today. Factors such as poor diet and lack of physical activity are some of the main contributors to the disease— and they are also elements most of us struggle to balance. In other words Lifestyle is the biggest contributor to your health as you can see in this video

Wearable devices designed with intuitive interfaces hold the possibility of helping us maintain that balance, remind us of our inactivity, track our daily caloric intake, remind us of how many hours, minutes, and days it has been since our last cigarette (even Spock spoke out against smoking)

When smart watches and fitness bands are tethered to mobile devices, we can layer on more practical applications for personal health management. What if you were walking down the street and your wearable could sense you were having a minor heart arrhythmia, send a signal to your phone, and have it call for help or advice? Or, perhaps, much like our phones can now alert us to poor traffic for our daily commute, what if your wearable, knowing you are diabetic, could sense low blood sugar, sync this data with your phone and tell you some appropriate restaurants and grocery stores nearby? They will be able to translate personal health data into steps and actions we, as patients, can take to better manage our care and keep ourselves healthier.

Engagement ROI

The benefits of an engaged patient population are numerous. Not only will people be healthier, but consider the above World Health Organization cardiovascular disease statistics and the associated costs of care, medication, and lost productivity, not to mention the personal impact on each of us. For coronary heart disease alone, the U.S. spends $108.9 billion. If people were more dialed in to their health— tracking, monitoring, and being rewarded by insurance companies for adherence to healthy lifestyle activities— imagine the savings both in lives and dollars. And with the pervasiveness of health IT innovation, we are seeing more consumer-facing health apps, such as Sharecare’s AskMD, becoming standard features on mobile devices. People can now use these apps to walk them through their symptoms, offer guidance on managing chronic conditions, and remind them to check in with their doctors.

We’ve come a long way from the shoe-box sized mobile phones of the ‘80s and it will be interesting to see a glimpse of our future technologies, widgets and devices on display at CES 2015. One thing is certain: whether you’re a physician or a patient, we’re all still consumers and our expectations for efficiency and conveniences on mobile devices will play a large role in the next phase our health evolution. In fact, I imagine the current wearable will be considered clunky and dated in as little as 10 years. We might find our lives equipped with even more svelte tools integrated with all of our healthcare data and real-time advisors, apps or avatars that coach, coerce or cheer us on through daily choices to keep our lives and health on the ideal track.